Increased Prevalence of Eosinophilic Esophagitis in Patients With Chronic Rhinosinusitis

Am J Rhinol Allergy. 2022 Nov;36(6):804-807. doi: 10.1177/19458924221116162. Epub 2022 Sep 12.

Abstract

Background: Chronic rhinosinusitis (CRS) and eosinophilic esophagitis (EoE) are immune-mediated inflammatory conditions that share common histopathologic features. Once considered two separate pathologies, preliminary data has suggested that a higher prevalence of EoE may exist in patients with CRS.

Objectives: We aimed to expand the base of evidence across geographic regions and investigate the association between EoE and CRS, including CRS with nasal polyposis (CRSwNP).

Methods: Quantitative data detailing the prevalence of CRS, CRSwNP, and EoE were pooled from 6 large academic institutions spread across the United States using Epic electronic medical record system. One-way analysis of variance was then used to analyze the data.

Results: The mean prevalence of EoE in our general population sample of over 26 million individual records was 0.058% (range, 0.013%-0.103%). The mean prevalence of EoE in our sub-populations of individual with diagnoses of CRS and CRSwNP was 0.43% (F(1,12) = [8.194], P = .01) and 0.84% (F(1,12) = [23.61], P < .01) respectively.

Conclusion: This study reveals an 8-fold greater prevalence of concurrent EoE in patients with CRS. Importantly, this is the first study to describe the association of EoE and the CRSwNP subtype, and we demonstrate a 14-fold greater prevalence of EoE in patients with CRSwNP.

Keywords: Th2-mediated inflammation; chronic rhinosinusitis; eosinophilic esophagitis; immune-mediated inflammation; nasal obstruction; nasal polyposis; post-nasal drip; rhinitis; rhinorrhea; sinusitis.

MeSH terms

  • Chronic Disease
  • Enteritis
  • Eosinophilia
  • Eosinophilic Esophagitis* / epidemiology
  • Gastritis
  • Humans
  • Nasal Polyps* / diagnosis
  • Prevalence
  • Rhinitis* / diagnosis
  • Sinusitis* / diagnosis

Supplementary concepts

  • Eosinophilic enteropathy